Pay for a course with a personal check, company check, money order, purchase order or voucher.

PLEASE PRINT ONE FORM FOR EACH COURSE PURCHASED.
(One check may be submitted for multiple purchases.)
Payment type:
Full name:
Company name:
NYSDEC Cert Number:
NYSDOH Cert Number:
Phone number:
E-mail:
Certification type:
Payment is for:
Amount to enclose:
Special notes:
I have filled out the registration for online courses. If not, go to registration. (Opens in new window.)
Note: If you have registered and taken courses before, please use the same Username and Password to enroll in new courses.

  Only after filling in all information,
  

Please print and include this page with your payment. If you do not have a printer, simply write down the information requested on this form and include it with your payment.

Make your company check or money order payable to the New York Rural Water Association and send to:

New York Rural Water Association
P.O.Box 487
Claverack, NY 12513

Note: You will receive an email when you are able to access the course. You will not receive your Certificate until NYRWA receives and processes your payment.